top of page
Search

Insurance Payer Demographic Updates: Links and Forms

  • Jun 3
  • 3 min read

Keeping your demographic information up to date with the insurance payers is important. If something changes (you change physical office locations, etc.) you need to update that information with the insurance payer. If you do not, this could impact reimbursement for services. I have included the links, forms, and instructions below for completing demographic updates with the major insurance payers in Kentucky.



Complete maintenance request online through PECOS Portal << --Access link here




Complete maintenance request online through Partner Portal << --Access link here




Complete update via Provider Express portal << --Access link here




Mail, fax, or email this form and supporting documentation to: Passport Health Plan by Molina Healthcare ATTN Provider Network Administration 2028 W. Broadway Louisville, KY 40203

Fax#: (833) 529-1081







  • WellCare of Kentucky<< --Access link to the form here




  • Carelon<< --Access link to the provider portal here

Contact Provider Services and get Internal Inquiry Number, 800-397-1630. Complete Change of Address Packet for individual providers. For group of providers, complete Change of Address Packet and group roster. MAKE SURE YOU REQUEST PROVIDER ID FROM AGENT ON CALL- this needs to be included on the group roster and change of address packet. Fax to: 866-612-7795

All provider demographic updates should be sent via the Carelon Behavioral Health provider portal and the provider’s CAQH profile. When updating your CAQH profile, it is important to select “Global” for your access to ensure Carelon Behavioral Health can review these changes to your data. You may also contact the Carelon Behavioral Health National Provider Services Line at 1-800-397-1630, from 8:00 a.m. to 8:00 p.m. ET/7:00 a.m. to 7:00 p.m. CT, Monday through Friday to update your demographic information.



Complete roster, email with W9 to KYBHMedicaid@humana.com




Online Form




  • Cigna Evernorth<< --Access link to the provider portal here

If you need to correct or update your information, please choose from the following options: Visit the My Practice section of your secure dashboard.* The easy-to use online forms are located under Update Provider Information. 

Call Provider Services at 1.800.926.2273 and say "health care professional" or select prompt #2, then say "something else" or choose prompt #6 to be connected to a provider advocate.




All demographic updates to a group location require a new location to be built, unless it is just a Suite number, phone or fax that need updated. If the provider is already TRICARE certified, you can add them via your portal to the group location they will be joining. If they aren’t certified, you will need to complete the certification application for them. All of the steps are listed below for you.

 

To update a group location suite, phone or fax number, please follow the below steps.  To verify what updates can be made, hover over the question mark for what data can be updated. 

·         Click on the “View/Update” or “View” hyperlink under the Group Information banner

·         Click “Edit information” in the box at top right-hand corner

·         Next click “Update group location”                                                                                              

·         Update “Address line 1” with suite number only

·         Update “Ref & auths fax, Business fax, and/or Phone” if necessary and click “Continue”

·         Additional fields: Telehealth capabilities, hours, limitations, emails, and website. 

·         Continue through prompts and click “Submit Changes”

 

You can add a new group location on the provider portal. Please follow the below instructions.

 

·         Click “View/Update” or “View” hyperlink under the Group Information banner

·         Click “Edit information” in the box at top right-hand corner

·         Click “Add new group location”

·         Follow prompts to add all necessary information:  Please refrain from using any special characters in the group name or address such as periods, apostrophes, hyphens, ampersands, etc.

·         You must upload a W-9 before submitting for the request to process

 

If the new location does not populate in your provider portal after 30 business days from submission, please send a secure message and let the provider rep know.


 
 
 

Comments

bottom of page